Intended for healthcare professionals

Letters Spotlight: Patient Centred Care

How can we get better at providing patient centred care: does continuity matter?

BMJ 2015; 350 doi: (Published 10 March 2015) Cite this as: BMJ 2015;350:h1127
  1. Charlotte Paddison, senior research associate1
  1. 1Cambridge Centre for Health Services Research, Institute of Public Health, University of Cambridge, Cambridge CB2 0SR, UK
  1. camp3{at}

Contributors to The BMJ’s roundtable debate “How can we get better at providing patient centred care?” think that new electronic decision aids, patient access to clinician notes online, and care plans for people with long term conditions are the way forward.1 These seem like useful suggestions, except perhaps for care plans—see what a colleague’s research found that patients thought about them.2

Call me old fashioned, but I agree with the contributors—ultimately “healthcare is about relationships.”

If person centred care is about understanding patients’ needs and priorities, then seeing the same doctor at each visit (relational continuity) would seem an important goal. Our recent research using the national general practice patient survey shows that 25% of people with diabetes who preferred to see a particular doctor could not do so.3 Can we do better? I think we can, and should.

Primary care has a crucial role here. GPs are well placed to provide care that gives continuity over time, enabling clinicians to understand patients’ personal circumstances and social history, and to explore their health needs and priorities in the context of their “life world.” In short, to provide care that puts the person at the centre. Continuity of care is especially important in people with multimorbidity.4

So how can we get better at providing patient centred care? The BMJ spotlight emphasises the use of technologies to engage and empower patients,1 but it might be just as important to promote better relational continuity. This is not expensive and doesn’t require new resources, but it’s perhaps not quite as sexy as the latest wearable activity trackers and patient apps on the iPad.


Cite this as: BMJ 2015;350:h1127


  • Competing interests: None declared.

  • A related blog, “What can we do to promote person-centred primary care?” can be found at the Cambridge Centre for Health Services Research.